Healthcare Provider Details

I. General information

NPI: 1881736635
Provider Name (Legal Business Name): RICHARD STEPHEN SANDOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22011 VENTURA BLVD
WOODLAND HILLS CA
91364-1646
US

IV. Provider business mailing address

2546 ARMSTRONG AVE
LOS ANGELES CA
90039-2634
US

V. Phone/Fax

Practice location:
  • Phone: 818-916-6869
  • Fax: 818-235-0100
Mailing address:
  • Phone: 310-386-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberG24749
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: